在存在G6PD缺乏的情况下,HbA1c在识别异常葡萄糖耐受性方面表现不佳:来自美国非洲人研究的洞察力
Amy R Bentley1, Kauthrah Ntabadde2, Claudine B Kabeza2
1Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, United States of America.
使用血红蛋白A1c (HbA1c) 的葡萄糖耐受性查在患有葡萄糖-6-酸脱酶缺乏症 (G6PD-D) 的个人中是不可靠的. G6PD-D显著降低了HbA1c,可能导致错过了异常葡萄糖耐受性的诊断.
科学领域:
- 临床生物化学 临床生物化学
- 遗传学 遗传学 是一个
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 葡萄糖-6-酸脱酶缺乏症 (G6PD-D) 在非洲人群中很普遍,在非洲人群中,异常葡萄糖耐受性 (Abnl-GT) 也很常见.
- 血红蛋白A1c (HbA1c) 广泛用于诊断Abnl-GT,但已知G6PD-D可以降低HbA1c水平.
- 在G6PD-D患者中,对Abnl-GT的HbA1c的诊断准确性仍然令人担忧,特别是在风险人群中.
研究的目的:
- 评估HbA1c在检测G6PD-D个体中的Abnl-GT的有效性.
- 评估G6PD-D状态的基因检测 (基因型定型) 和酶分析之间的一致性.
- 研究G6PD-D对生活在美国的撒哈拉以南非洲人HbA1c测量的影响.
主要方法:
- 分析了来自美国非洲人研究的534名参与者的队列.
- 使用口服葡萄糖耐受性测试 (OGTT) 作为黄金标准来诊断Abnl-GT.
- 将HbA1c与OGTT结果进行比较,并通过基因型和/或酶定检测确定G6PD-D状态.
主要成果:
- 患有G6PD-D的参与者表现出HbA1c水平大约比正常G6PD活动的参与者低0.9% (4.6%对5.5%).
- 在患有G6PD-D的个体中,HbA1c对Abnl-GT具有0%的敏感性和100%的特异性.
- 对G6PD-D的基因型和酶分析显示出100%的一致性,但酶分析对异卵性女性至关重要.
结论:
- 由于HbA1c值明显较低,HbA1c是G6PD-D患者异常葡萄糖耐受性的不可靠查工具.
- 对G6PD-D的酶定量对于准确的诊断至关重要,特别是在异卵性女性中,并且与基因型定型高度一致.
- 如果不考虑G6PD-D,可能导致低诊断和低治疗异常葡萄糖耐受性,可能增加并发症风险.
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